The effects of head and body positioning on upper airway collapsibility in normal subjects who received midazolam sedation.


STUDY OBJECTIVE:To test the hypothesis that the change of body and head position affects upper airway patency during midazolam sedation. DESIGN:Clinical study using 30 healthy subjects. SETTING:Research unit for sleep study. INTERVENTIONS:We used a pressure-flow relationship to evaluate critical closing pressure (Pcrit) and upper airway resistance (Rua) in different condition of body and head position. A pressure-flow relationship was obtained in 3 body postures (supine, 15 degrees elevation, and 30 degrees elevation) and was obtained in 3 head positions (supine with the head in the neutral, supine with head extension, and supine position with head rotated). MEASUREMENTS:The pressure and inspiratory flow at subjects' nose mask were recorded. Polysomnographic parameters (electroencephalograms, electrooculograms, submental electromyograms, upper esophageal pressure, and plethysmogram) were also recorded. MAIN RESULTS:In experiment 1, 30 degrees elevation of the body significantly decreased Pcrit (P < 0.05) to -13.3 +/- 1.3 cm H(2)O compared with -8.2 +/- 1.4 cm H(2)O in supine condition without changing the slope (1/Rua). In experiment 2, head extension significantly decreased Pcrit (-12.5 +/- 1.3 cm H(2)O) (P < 0.05) compared with the value (-8.2 +/- 1.0 cm H(2)O) in supine condition without changing the slope (1/Rua). CONCLUSIONS:Our findings indicate that 30 degrees body elevation and head extension significantly decreased upper airway collapsibility during midazolam sedation and established the relative potency of maneuvers that maintain upper airway patency.


J Clin Anesth


Ikeda H,Ayuse T,Oi K




Has Abstract


2006-05-01 00:00:00














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    abstract:STUDY OBJECTIVE:To quantify global coagulation and establish normal ranges for the celite-activated thrombelastograph (TEG) in healthy pediatric patients. DESIGN:Prospective observational study. SETTING:Operating suite of a university-based hospital. PATIENTS:110 healthy pediatric patients in four age groups and 25 ...

    journal_title:Journal of clinical anesthesia

    pub_type: 临床试验,杂志文章


    authors: Pivalizza EG,Pivalizza PJ,Gottschalk LI,Kee S,Szmuk P,Abramson DC

    更新日期:2001-02-01 00:00:00

  • A hospital administrator's view of the operating room.

    abstract::The need for greater efficiency in OR management will become apparent as hospitals are forced to respond to a myriad of pressures imposed by the external environment. The most effective strategy in dealing with this challenge will be realized by adopting a "systems" approach to OR functions as opposed to the more trad...

    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: Jeon AA

    更新日期:1995-11-01 00:00:00

  • Teaching without a teacher: developing competence with a Bullard laryngoscope using only a structured self-learning course and practicing on a mannequin.

    abstract:STUDY OBJECTIVE:To show that a complex motor skill can be taught without requiring active expert faculty participation. DESIGN:Prospective descriptive study. SETTING:Simulation laboratory of an academic anesthesiology department. SUBJECTS:Novice users of the Bullard laryngoscope, predominantly residents. INTERVENTI...

    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: Pott LM,Santrock D

    更新日期:2007-12-01 00:00:00

  • Airway involvement and anesthetic management in Goltz's syndrome.

    abstract::A 13-year-old girl with Goltz's (Goltz-Gorlin) syndrome (focal dermal hypoplasia) and cloacal exstrophy underwent day surgery cystoscopy. During the administration of inhalation anesthesia by mask, persistent partial upper airway obstruction was noted. Direct laryngoscopy unexpectedly showed variously sized verrucous ...

    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: Holzman RS

    更新日期:1991-09-01 00:00:00

  • Postoperative analgesia for hip arthroscopy: combined L1 and L2 paravertebral blocks.

    abstract::Two patients are presented who underwent successful combined L1 and L2 paravertebral blocks as part of an anesthetic technique for hip arthroscopy. ...

    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: Lee EM,Murphy KP,Ben-David B

    更新日期:2008-09-01 00:00:00

  • Intranasal dexmedetomidine premedication reduces the minimum alveolar concentration of sevoflurane for tracheal intubation in children: a randomized trial.

    abstract:STUDY OBJECTIVE:To determine the effects of dexmedetomidine premedication on the minimum alveolar concentration of sevoflurane for tracheal intubation (MACTI) in children. DESIGN:Prospective, randomized, clinical comparison study. SETTING:Operating room of an academic hospital. PATIENTS:90 pediatric, ASA physical st...

    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章,随机对照试验


    authors: Yao Y,Qian B,Chen Y,Zhou L,Liu J

    更新日期:2014-06-01 00:00:00

  • Unusual etiology of hyperkalemia in an immunocompromised patient.

    abstract::Hyperkalemia was found in an immunocompromised patient undergoing emergency cystoscopy. The cause of the hyperkalemia was an intraperitoneal rupture of the bladder. This case report discusses conditions that predispose patients to bladder rupture and anesthetic management of hyperkalemia. ...

    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: Newland MC,Hosman SL,Newland JR,Landers DF

    更新日期:1991-11-01 00:00:00

  • Carbon dioxide absorber as a cause of high airway pressures.

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    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: Bagdasarian LA,Shah NK,Sharif MK

    更新日期:2008-02-01 00:00:00

  • Ketorolac penetration into the cerebrospinal fluid of humans.

    abstract:STUDY OBJECTIVE:To determine the cerebrospinal fluid (CSF): total plasma concentration ratio of ketorolac tromethamine following a single intramuscular (IM) dose. DESIGN:Open, single-dose, IM-administration study. SETTING:General operating theaters of a medical school hospital. PATIENTS:29 ASA physical status I and ...

    journal_title:Journal of clinical anesthesia

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    authors: Rice AS,Lloyd J,Bullingham RE,O'Sullivan G

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  • The effect of nitrous oxide on intracuff pressure of the size 2 ProSeal Laryngeal Mask Airway.

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    journal_title:Journal of clinical anesthesia

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    authors: Chen BZ,Luo LH,Jiang L,Wang RR,Li J,Tan L

    更新日期:2011-05-01 00:00:00

  • Anesthetic challenges and outcomes for procedures in the intraoperative magnetic resonance imaging suite: A systematic review.

    abstract:BACKGROUND AND OBJECTIVE:Hybrid operating room suites with intraoperative magnetic resonance imaging enable image guided surgery in a fully functional operating room environment. While this environment creates challenges to anesthetic care, the effects on anesthetic adverse events and outcomes are largely unknown. This...

    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: Schroeck H,Welch TL,Rovner MS,Johnson HA,Schroeck FR

    更新日期:2019-05-01 00:00:00

  • Brugada ECG disclosed by acute malaria: is it all about fever and propofol?

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    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: Meggiolaro M,Zorzi A,El Maghawry M,Peruzza F,Migliore F,Pittoni GM

    更新日期:2013-09-01 00:00:00

  • Oral ketamine facilitates induction in a combative mentally retarded patient.

    abstract::Induction of general anesthesia in the agitated or combative mentally retarded patient is challenging. Oral ketamine facilitated the smooth and safe induction of anesthesia in an adult mentally retarded patient with a history of violent behavior toward health care providers. The oral administration of ketamine is an e...

    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: Bragg CL,Miller BR

    更新日期:1990-03-01 00:00:00

  • Anesthesiology residents' perception of educational environment: comparison between different years of training.

    abstract:STUDY OBJECTIVES:To assess whether the year of residency in anesthesiology is associated with residents' overall perceptions of the learning environment and to evaluate the association between year of residency and each of the five domains of the Dundee Ready Education Environment Measure (DREEM) survey. DESIGN:Cross-...

    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: Riveros-Perez E,Riveros R,Zimmerman NM,Turan A

    更新日期:2016-12-01 00:00:00

  • Ulnar artery versus radial artery approach for arterial cannulation: a prospective, comparative study.

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    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章,随机对照试验


    authors: Karacalar S,Ture H,Baris S,Karakaya D,Sarihasan B

    更新日期:2007-05-01 00:00:00

  • Hemodynamic stability and patient satisfaction after anesthetic induction with thiopental sodium, ketamine, thiopental-fentanyl, and ketamine-fentanyl.

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    journal_title:Journal of clinical anesthesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Katz RI,Lagasse RS,Levy A,Alexander G

    更新日期:1993-03-01 00:00:00

  • Increased propofol requirement during succeeding administrations for electroconvulsive therapy.

    abstract:STUDY OBJECTIVE:To study patients' requirement for propofol dosages during the course of repeated deep sedation for electroconvulsive therapy (ECT). DESIGN:Prospective study. SETTING:Outpatient psychiatric clinic in a tertiary-care, university-affiliated, 1100-bed metropolitan hospital. PATIENTS:30 patients undergoi...

    journal_title:Journal of clinical anesthesia

    pub_type: 临床试验,杂志文章


    authors: Cohen Y,Feldinger E,Ogorek D,Weinbroum AA

    更新日期:2004-06-01 00:00:00

  • Impact of deep hypothermic circulatory arrest on the BIS index.

    abstract:STUDY OBJECTIVE:To investigate the influence of duration of deep hypothermic circulatory arrest (DHCA) on recovery of the bispectral index (BIS). DESIGN:Prospective cohort study. SETTING:Operating room of university teaching hospital. PATIENTS:30 adult, ASA physical status III and IV patients scheduled for cardiac s...

    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: Ziegeler S,Buchinger H,Wilhelm W,Larsen R,Kreuer S

    更新日期:2010-08-01 00:00:00

  • Comparison of propofol with thiopental and isoflurane for induction and maintenance of general anesthesia.

    abstract::Propofol, a phenol compound with a short elimination half-life, was compared with thiopental and isoflurane for induction and maintenance of general anesthesia in 60 consenting ASA I, II, and III patients. The study was randomized and open label in design. Hemodynamically, the propofol patients showed a mean +/- SEM d...

    journal_title:Journal of clinical anesthesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Gold MI,Sacks DJ,Grosnoff DB,Herrington CA

    更新日期:1989-01-01 00:00:00

  • Action of β-endorphin and nonsteroidal anti-inflammatory drugs, and the possible effects of nonsteroidal anti-inflammatory drugs on β-endorphin.

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    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章,评审


    authors: Luan YH,Wang D,Yu Q,Chai XQ

    更新日期:2017-02-01 00:00:00

  • The effect of fentanyl on hemodynamic and bispectral index changes during anesthesia induction with propofol.

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    journal_title:Journal of clinical anesthesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Nakayama M,Ichinose H,Yamamoto S,Kanaya N,Namiki A

    更新日期:2002-03-01 00:00:00

  • Tracheal width and left double-lumen tube size: a formula to estimate left-bronchial width.

    abstract:STUDY OBJECTIVE:To determine which patient parameters best predict left bronchial width (LBW) when selecting the correct size double-lumen tube (DLT). If LBW is known, a DLT that will fit that bronchus can be chosen. DESIGN:Prospective study. SETTING:University medical center. PATIENTS:Three hundred twenty-one conse...

    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: Brodsky JB,Lemmens HJ

    更新日期:2005-06-01 00:00:00

  • Postoperative analgesia and intraoperative inhalational anesthetic requirements during umbilical herniorrhaphy in children: postincisional local infiltration versus preincisional caudal epidural block.

    abstract:STUDY OBJECTIVE:To determine the postoperative analgesic efficacy of, and the effects on, intraoperative inhalational anesthetic requirements of preincisional caudal epidural block versus postincisional infiltration of local anesthetic following umbilical herniorrhaphy in children. DESIGN:Randomized, double-blind, pro...

    journal_title:Journal of clinical anesthesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Tobias JD

    更新日期:1996-12-01 00:00:00

  • Evaluation of anxiolysis and pain associated with combined peri- and retrobulbar eye block for cataract surgery.

    abstract:STUDY OBJECTIVES:To evaluate five different preoperative anxiolytic regimens in cataract surgery performed under regional anesthesia; to quantify the pain associated with combined peri- and retrobulbar injection (PRBI) of local anesthetic drugs; and to describe a technique of painless eye block. DESIGN:Randomized, dou...

    journal_title:Journal of clinical anesthesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Boezaart AP,Berry RA,Laubscher JJ,Nell ML

    更新日期:1998-05-01 00:00:00

  • Isoflurane hepatitis-induced liver failure: a case report.

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    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: Peiris LJ,Agrawal A,Morris JE,Basnyat PS

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  • Aprotinin does not prolong the Sonoclot aprotinin-insensitive activated clotting time.

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    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: Dong Y,Nuttall GA,Oliver WC Jr,Agarwal S,Ereth MH

    更新日期:2007-09-01 00:00:00

  • Rocuronium is associated with an increased risk of reintubation in patients with soft tissue infections.

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    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


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    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: Waldron NH,Stolp BW,Ogilvie MP,Powers DB,Shaughnessy MR

    更新日期:2016-11-01 00:00:00

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    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章,随机对照试验


    authors: Vigoda MM,Behrens V,Miljkovic N,Arheart KL,Lubarsky DA,Dutton RP

    更新日期:2012-09-01 00:00:00

  • Economic considerations in the use of neuromuscular blocking drugs.

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    journal_title:Journal of clinical anesthesia

    pub_type: 杂志文章


    authors: DeMonaco HJ,Shah AS

    更新日期:1994-09-01 00:00:00